Abstract

Promoting transfer of clinical skills from simulation to hospital settings: the role of clinical nurse educators in medical education

Author(s): Associate Professor Robyn Hill,Professor Debra Nestel,Ms Jill French

Introduction: Gippsland Medical School (GMS) offers a fouryear graduate-entry program in rural Australia. Students learn clinical skills in a simulation centre then gain clinical experience in hospitals. In the first year, students learn in simulated and hospital settings.

Clinical Nurse Educators (CNEs) were recruited to support clinical skills teaching in both settings. The aim of this innovation was to optimise students’ transfer of skills from simulation to clinical settings through consistent, sensitive and supportive supervision from CNEs. This active structured role for CNEs raises their profile as medical educators, promotes collaborative learning and is cost effective.

Methods: This paper describes the evaluation of the CNE program in facilitating transfer of learning. Questionnaires and focus groups were used. Quantitative data from the questionnaires were analysed using descriptive statistics and focus group transcripts analysed thematically.

Results: Forty-eight students (response rate = 84%) and five CNEs (response rate = 71%) completed questionnaires. Twentyeight students and all CNEs participated in focus groups. Students reported that they were able to transfer skills from simulation to hospital settings. CNEs were able to target supervision and arrange individualised learning experiences. Relationships developed in the simulation setting were crucial to learning in hospitals. CNEs valued their role and reported expansion of their clinical skills repertoire. CNEs believed as members of a clinical skills team they delivered a structured curriculum, nurtured novice medical students and facilitated the transfer of skills to clinical settings.

Discussion: CNEs can encourage students’ orientation into the clinical setting, link clinical activities with those learned in simulation, support students’ development of clinical communication skills and supervise and assess procedural skills in the hospital setting. Early hospital placements are a strength of this graduate entry medical program. Our results demonstrate that CNEs model communication and other professional skills thus facilitating socialisation of medical students into the hospital setting. Students’ consider that their consistent engagement with CNEs enables transfer of learning. Furthermore, the students valued CNEs as academics and clinicians. Limitations of the project are outlined. We conclude that CNEs enhance the teaching and assessment process in simulation and hospital settings.